An Open-Label Pilot Study Using Contingency Management to Decelerate Risky Behaviors Among People Who Inject Drugs in Albania

Abstract

Introduction: Even though needle exchange programmes (NEP) are considered the single most important HIV prevention strategy for People Who Inject Drugs (PWID), yet the irregular uptake of services remains a challenge. To mitigate the harms of injecting drug use and increase access to prevention services, the approach of Contingency Management (CM) was implemented as an adjunct to the current NEP in Tirana, Albania. CM provides tangible rewards for clients to increase/decrease the frequency of target behaviours. The intervention hypothesized that using the reward system via CM might help to ensure regular use of prevention services. Method: Eighty clients who were currently injecting drug users were equally divided in experimental and control groups. The intervention was conducted for eight months: two months were dedicated to the development and validation of the research protocol and six ones for the implementation phase. Results: Compared with the control group, participants of the experimental ones had higher rates (up to threefolds) of daily attendance of the NEP. All of them, have been tested for HIV and Hepatitis Viral B&C (HVB&C), compared with 35% of those from the control group. One-third, introduced the sexual/injecting partner and the number of new female PWID introduced by clients of experimental group was significantly higher than the other one. Conclusion: This intervention indicated the need for using innovative approaches to motivate PWID in using on regular bases prevention services. Regular uptake of NEP implies reduction in injection-related drug-taking behaviours and lesser risks for getting or transmitting HIV/HVB&C.